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. 2023 Jan 6;14(4):326-333.
doi: 10.1136/flgastro-2022-102307. eCollection 2023.

UK national trainee survey of hepatology training, research and the future workforce

Wenhao Li  1 , Nadir Abbas  2 , Paul N Brennan  3 , Hannah Mcdowell  4 , Janardhan Navaratnam  5 , Anju Phoolchund  6 , Robert Scott  7 , Jessica Shearer  8 , Helen White  9 , Oliver D Tavabie  10
Affiliations

UK national trainee survey of hepatology training, research and the future workforce

Wenhao Li et al. Frontline Gastroenterol. .

Abstract

Objective: The increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and trainee attitudes towards future careers in hepatology.

Method: An electronic survey was distributed to higher specialty gastroenterology and hepatology trainees in the UK between March and May 2022.

Results: 138 trainees completed the survey covering all training grades and regions of the UK. 73.7% reported receiving adequate hepatology training currently, with 55.6% intending to become future hepatologists. Trainee preference for future hepatology consultant posts in specialist liver centres were almost threefold higher compared with district general hospitals (60.9% vs 22.6%). All trainees, irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. Senior trainees (grade ST6 and higher), without advanced training programme (ATP) experience reported significantly lower confidence in managing viral hepatitis, hepatocellular carcinoma and post-transplant patients compared with equivalent trainees with ATP experience. For junior trainees (IMT3-ST5), remaining in their current deanery was the most important factor when considering future hepatology training application.

Conclusions: There is a significant need to deliver widely available training on the management of complex liver disease to improve non-ATP trainee confidence. Innovative job planning strategies are required to encourage trainees to pursue careers outside of specialist liver centres. Expansion of hepatology training networks with wider geographical coverage are needed to address the growing need for more hepatologists around the UK.

Keywords: HEALTH SERVICE RESEARCH; LIVER.

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Conflict of interest statement

Competing interests: PNB has received an educational honorarium from Takeda. ODT has received an educational honorarium from Gilead Sciences. ODT is trainee editor for Frontline Gastroenterology.

Figures

Figure 1
Figure 1
Trainee demographics. (A) Regional representation of trainee survey by NHS region expressed as percentage of total survey participants. (B) Trainees split by grades. (C) Trainees split by gender. (D) Trainees split by age group. (E) Trainees split by employment. (F) Trainees split by ethnicity. (G) Trainees split by liver centre designation. FT, full time; LTFT, less than full time; NHS, National Health Service.
Figure 2
Figure 2
Trainee self reported confidence level in managing liver diseases. (A) Inpatient setting (all trainees). (B) Outpatient setting (all trainees). (C) Inpatient setting (senior trainee (ST6+) split by hepatology ATP experience). (D) Outpatient setting (senior trainee (ST6+) split by hepatology ATP experience). ATP, advanced training programme.
Figure 3
Figure 3
Factors influencing hepatology ATP application in junior trainees (IMT3 to ST5). ATP, advanced training programme.
Figure 4
Figure 4
Trainee out of programme research (OOPR) experience. (A) Regional representation of total OOPR trainee numbers. (B) type of research conducted during OOPR. (C) Area of liver disease research. (D) Factors influencing hepatology research application. OOPR, out of programme research.
Figure 5
Figure 5
Infographic highlighting the current challenges and potential solutions for hepatology training, research, hepatology ATP and future hepatology consultant career planning. ATP, advanced training programme.
See this image and copyright information in PMC

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